Patients with dysphagia requiring long-term NG tubes (>3 months), neuromuscular disorders, post-head and neck cancer, post-stroke dysphagia, or frailty with reduced oropharyngeal muscle strength.

Lotung Poh-Ai Hospital established the Swallowing Function Center in July 2020 and the NG Tube Removal Ward in May 2021, becoming the leading swallowing function restoration unit in Yilan. Standardized care models include OHAT oral care workflow, Shared Decision Making (SDM), and NG tube removal risk-stratified care, with electronic case management integration. The center features VFSS (videofluoroscopy), FEES (fiberoptic endoscopy), rTMS (repetitive transcranial magnetic stimulation), functional pharyngeal electrical stimulation, and electromyography biofeedback. Integrated multidisciplinary teams cover rehabilitation, nutrition, head and neck cancer, and botulinum toxin injections. Since 2021, cumulative 384 patients enrolled with 298 successful NG tube removals. 2024 NG removal success rate 79%; quality indicators all met; 0% 14-day unplanned readmission; 0% 30-day pneumonia rate. 2024 satisfaction: 91% with 100% questionnaire return rate.

• Standardized enrollment and care model

• NG tube removal risk-stratified model

• rTMS + functional electrical stimulation

• Electronic case management integration

• Multidisciplinary team (rehab/nutrition/H&N cancer)

• Shared Decision Making (SDM)

• Cumulative enrollment since 2021: 384

• Successful NG removals: 298

• VFSS 385, FEES 102 sessions

• rTMS 125 sessions

• Pharyngeal stimulation: 634 sessions

• 2024 SDM execution: 12 patients

• NG removal success rate 79% (2024), 82% (2023)

• High risk 78%, medium 76%, low 93%

• FOIS improvement >1 level: 74.2%

• IDDSI progression >1 texture: 74%

• Water intake target: 86.8%

• Screening form execution: 98%

• 14-day unplanned readmission: 0%

• 30-day pneumonia post-NG removal: 0%

• Inpatient pneumonia mortality: 3.6%

• Safe eating education rate: 95.4%

• Nutritional assessment & education: 100%

• Standardized OHAT oral care

• 2024 overall satisfaction: 91%

• Satisfied+ rate: 96.9%

• Questionnaire response: 100% (13/13)

• Patients regain oral eating enjoyment

• Reduces caregiver long-term burden

• Significantly improves dignity

• 4 swallowing papers in past 3 years

• International dysphagia society publications

• 2 SCI papers

• Rehabilitation Society, Dysphagia Society presentations

• Advisor: NTUH VP / President of Taiwan Dysphagia Society

• Improves Yilan dysphagia care accessibility

• Reduces long-term NG-related complications

• Improves patient QoL and dignity

• Lowers aspiration pneumonia incidence

• Reduces family and long-term care burden